IntroductionWnts comprise a highly conserved family of secreted glycoproteins, consisting of 19 members, that bind to the Frizzled receptors alone or complexed with the low-density lipoprotein receptorrelated proteins (LRPs) 5/6. In vertebrates, Wnts can activate a "canonical" -catenin-dependent pathway or several -cateninindependent "noncanonical" pathways. 1,2 The canonical pathway is normally repressed at several levels. An intracellular complex, including GSK-3, axin, and the tumor suppressor gene product APC, functions to phosphorylate -catenin, which in turn targets it for ubiquitin-mediated proteasomal degradation. On Wnt binding, -catenin degradation is blocked, leading to its accumulation and translocation to the nucleus, where it binds the TCF/LEF family of transcription repressors, turning them into transcriptional activators. 1,3 Mounting evidence suggests that canonical Wnt signaling is central to normal skeletogenesis 4-6 and cancer-related bone diseases. 7,8 The first direct evidence of a role for Wnt signaling in human bone formation came from observations that inactivating mutations of the LRP5 gene, a coreceptor for Wnt, causes a syndrome associated with early-onset osteoporosis. 9 Subsequently, it was shown that a separate and distinct mutation in the same gene results in high bone density. 10,11 Expression of Wnt10b in transgenic mice increases bone mass, 12 and overexpression of Wnt7B and -catenin in C3H10T1/2 osteoblastic precursor cells induces their differentiation into mature osteoblasts. 13,14 Osteoclastogenesis is primarily regulated by receptor activator of the NF-B ligand (RANKL) binding to RANK on the surface of osteoclast precursor cells. The ability of RANKL to bind RANK, and hence promote osteoclast development, is tightly regulated by the RANKL decoy receptor, osteoprotegerin (OPG). 15,16 Remarkably, recent studies have shown that Wnt signaling in cells of the osteoblast lineage positively regulates the expression of OPG 17,18 while negatively regulating RANKL. 19 Taken together these studies suggest that Wnt signaling is likely to be a central regulator of bone remodeling through its direct effects on osteoblastogenesis and indirect effects on osteoclastogenesis.Multiple myeloma (MM) is a malignancy of antibody-secreting plasma cells that specifically accumulate in the bone marrow (BM) but not other organs. This bone tropism suggests that the BM provides a unique microenvironment of growth and survival signals for MM cells. MM, but not its benign precursor condition, monoclonal gammopathy of undetermined significance (MGUS), is characterized by osteolytic bone disease, which can be traced to an uncoupling of bone remodeling as a result of increased osteoclast activity and decreased osteoblast activity. [20][21][22] During the past 3 decades numerous experimental and clinical studies have focused on the role of osteoclast in the osteolytic phenotype, and numerous factors associated with increased osteoclast activity in MM have been identified. 23 We recently found that MM t...